Dysphagia due to systemic light chain amyloidosis revealed by videoendoscopic and videofluorographic swallowing examinations
| Autor: | Masafumi Ohki, Shigeru Kikuchi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pathology
medicine.medical_specialty Glottis 03 medical and health sciences chemistry.chemical_compound Videofluoroscopy 0302 clinical medicine Swallowing stomatognathic system medicine otorhinolaryngologic diseases Esophagus business.industry Videoendoscopy Amyloidosis Pharynx digestive oral and skin physiology medicine.disease lcsh:Otorhinolaryngology Dysphagia lcsh:RF1-547 Barium sulfate medicine.anatomical_structure Peripheral neuropathy Otorhinolaryngology chemistry 030211 gastroenterology & hepatology medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Otolaryngology Case Reports, Vol 6, Iss C, Pp 4-6 (2018) |
| ISSN: | 2468-5488 |
| Popis: | Purpose Pharyngeal symptoms related to amyloidosis are quite rare, and there are no reports demonstrating videoendoscopic (VE) or videofluorographic (VF) swallowing examinations. We report a case of systemic light chain amyloidosis with dysphagia at the pharyngeal phase of swallowing revealed by VE and VF, and discuss the causative mechanisms. Case A 77-year-old man presented with a 6-month history of dysphagia. An oral cavity examination revealed normal findings. Laryngofiberscopy did not show space-occupying lesions or laryngeal nerve palsy. VE revealed a crystal violet-pigmented bolus that flowed into the pharynx toward the glottis before laryngeal elevation, and then pooled in the piriform recess of the hypopharynx and was aspirated into the trachea. VF using barium sulfate showed delayed onset and poor laryngeal elevation, aspiration during swallowing, poor pharyngeal contraction, and bolus residue in the piriform recess of the hypopharynx. Opening of the upper esophageal sphincter was adequate. Flow in the esophagus was normal. The number of swallowings was increased to clear the bolus from the pharynx. VE and VF indicated impairment during the pharyngeal phase of swallowing. Histopathological analysis of the lower lip demonstrated degeneration of the minor salivary glands and hypertrophic basal membranes due to amyloid deposits; the acini and ducts had been replaced by amyloid deposits of λ light chain (AL) amyloidosis. Discussion The possible mechanisms of pharyngeal phase impairment are peripheral neuropathy of the swallowing-related nerves and amyloid myopathy. Conclusion Systemic amyloidosis may cause pharyngeal phase dysphagia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|